Current health behaviors and readiness to pursue life-style changes among men and women diagnosed with early stage prostate and breast carcinomas

BACKGROUND: Cancer survivors are at increased risk for developing secondary tumors, diabetes, osteoporosis, and cardiovascular disease, thus making them an important target population for health-related interventions. However, little is known regarding cancer survivors' behaviors and their interest in pursuing healthier diets, exercise, and smoking cessation. METHODS: A 65-item survey was mailed to 1667 patients diagnosed with early stage carcinoma of the breast or prostate that requested data regarding demographics, health behaviors, stage of readiness for smoking cessation, exercise, increased fruit and vegetable (F&V) consumption, and decreased fat intake, as well as interest in specific health programs and when, relative to diagnosis, these programs should be offered. RESULTS: Responses from 978 cancer survivors suggested that the overwhelming majority (85%) reported their health as good to excellent. The majority of respondents (55%) ate fewer than 5 daily servings of F&Vs, with prostate carcinoma patients reporting eating significantly fewer servings than patients with breast carcinoma (P < 0.001). In contrast, 69% of respondents reported adherence to a low fat diet, again with lower practice rates among prostate carcinoma patients than patients with breast carcinoma (P = 0.006). The majority of respondents (58%) reported routine exercise and 8% were current smokers. Significantly more breast carcinoma patients than prostate carcinoma patients were current smokers (P = 0.03). There was strong interest in health promotion programs across behaviors, and a fair amount of concordance between low fat dietary behaviors and exercise, as well as consumption of five daily servings of F&Vs. The majority of patients expressed a preference for programs that could be delivered via mailed brochure, with 57% of respondents indicating that programs should be initiated at the time of diagnosis or soon after (within 6 months). CONCLUSIONS: The results of the current study suggest that although many cancer survivors already practice healthy life-style behaviors, there is a substantial proportion who do not. Interventions especially are needed to increase daily F&V intake; however, given the fair degree of clustering between dietary and exercise behaviors, multiple risk factor interventions also may be warranted. Among cancer survivors, receptivity is high for health promotion programs, especially those that can be delivered by mail and soon after diagnosis.     

Adaptation of pregnant ewes to an exclusive onion diet

A diet consisting entirely of cull onions fed to pregnant ewes produced Heinz body hemolytic anemia in all sheep after 21 d. After 28 d of daily consumption of 20 kg of onions/ewe, the anemia stabilized, and for the remaining 74 d the packed cell volume increased in the majority of sheep, although it did not return to normal. Compared to control ewes fed an alfalfa and grain diet, the onion-fed ewes had comparable body condition scores and fleece weights. There was no significant difference (alpha = 0.05) in pregnancy or lambing rate, number of lambs born/ewe exposed, or number of lambs born/ewe lambing. Greater numbers of sulfate-reducing bacteria (Desulfovibrio spp) and more ruminal hydrogen sulfide were present in onion-fed sheep compared to controls. Although an average 27% reduction in packed cell volume and Heinz body anemia developed in the onion-fed ewes, on the basis of this study it appears that pregnant ewes may be fed a pure onion diet with minimal detrimental effects. This adaptation to a pure onion diet is in part likely due to the apparent ability of the sheep's rumen to quickly develop a population of sulfate-reducing bacteria that decrease the toxicity of onion disulfides.     

Plastic bullet injuries in Northern Ireland: experiences during a week of civil disturbance

BACKGROUND: Plastic bullets were introduced to Northern Ireland for riot-control purposes in 1973. Their use has been controversial, with a number of fatalities. In the week beginning July 7, 1996, some 8,000 plastic bullets were fired during widespread rioting. METHODS: Details of injuries attributed to plastic bullets were obtained retrospectively from patient notes for the period July 8 to 14, 1996, in six hospitals. A total of 172 injuries in 155 patients were recorded. RESULTS: Nineteen percent of injuries were to the face/head/neck, 20% were to the chest or abdomen, and 61% were to the limbs. Abbreviated Injury Scale scores ranged from I to 3. Forty-two patients were admitted for hospitalization, three to intensive care units. No fatalities occurred. CONCLUSION: Plastic bullet impact to the abdomen or above may cause life-threatening injuries. Below this site, major trauma is unlikely.     

Apoptosis and radiosensitization of hodgkin cells by proteasome inhibition

PURPOSE: Malignant cells from Hodgkin's disease have been reported to be defective in regulation of NF-kappaB activity. Ionizing radiation is known to activate NF-kappaB, and it has been suggested that this pathway may protect cells from apoptosis following exposure to radiation and other therapeutic agents. Defective NF-kappaB regulation in Hodgkin cells could therefore dictate the response of this disease to therapy, as well as be responsible for maintaining the malignant phenotype. The purpose of this study was to explore whether NF-kappaB activity could be modulated in Hodgkin cells and whether it determines the response of these cells to treatment with ionizing radiation and/or dexamethasone. METHODS AND MATERIALS: Activation of NF-kappaB in cells is accomplished in large part by degradation of its inhibitor IkappaB through the 26s proteasome. HD-My-Z Hodgkin cells were treated with the proteasome inhibitor MG-132 or transduced with a dominant negative super-repressor IkappaBalpha. Clonogenic survival, apoptosis, proteasome activity, and NF-kappaB binding activity were monitored in response to ionizing radiation and/or dexamethasone treatment. RESULTS: HD-My-Z Hodgkin cells had modest NF-kappaB levels but, unlike other cell types, did not decrease their level of constitutively active NF-kappaB in response to proteasome inhibition with MG-132. In contrast, transduction with a non-phosphorable IkappaBalpha construct abolished expression. MG-132 did, however, induce apoptosis in HD-My-Z cells and sensitized them to ionizing radiation. Dexamethasone treatment had no effect on NF-kappaB activity or clonogenic survival of Hodgkin cells, but protected them from irradiation. CONCLUSION: We conclude that inhibition of 26s proteasome activity can induce apoptosis in HD-My-Z Hodgkin cells and radiosensitize them, in spite of the fact that their constitutively active NF-kappaB levels are unaltered. The proteasome may be a promising new therapeutic target for intervention in this disease. In contrast, the use of glucocorticoids in conjunction with radiation treatment for this tumor may require re-evaluation.     

A comparative volumetric analysis of the prefrontal cortex in human and baboon MRI

The proportion of prefrontal cortex in humans was compared to the proportion of prefrontal cortex in baboons (Papio anubis). Prefrontal cortex, dorsal prefrontal, orbital prefrontal cortex and total brain volumes were determined from magnetic resonance images of 20 healthy adult human females and 5 adult female baboons. Results showed that the proportion of prefrontal cortex volume relative to total brain volume in humans was significantly larger in humans than in baboons. The percentage of prefrontal cortex relative to total brain volume was 12.51 for humans and 10.68 for baboons. Similarly, the proportion of both dorsal and orbital prefrontal cortex volumes is larger in human brains. Relative to total brain volume, the percentages of dorsal and orbital prefrontal cortex was 8.22% and 4.29% respectively in humans and 7.21% and 3.47% in baboons. A regression analysis showed that the human prefrontal cortex was larger than would be predicted for a baboon of equal total brain volume. These results suggest that increased prefrontal lobe volume could underlie some of the differences between human and hominoid primates. On the other hand, the small magnitude of the difference might underlie similarities between the species and should encourage a search for other structures that are disproportionately larger in humans.     

Translating genetics, cognitive science, and other basic science research findings into applications for prevention

A growing body of research across genetics, cognitive science, and other basic science suggests the complexity and interconnectedness of multiple factors contributing to individual variation in susceptibility to engage in risk behaviors. Advances in these disciplines may direct new research directions and the development and evaluation of innovative intervention components for prevention that consider novel but central susceptibility factors. This article highlights findings from three interrelated areas of basic science research--genetics, neuroscience, and cognitive science--that together continue to inform prevention science. A primary objective of this article is to suggest how this research might guide primary prevention interventions. Translating findings from these disciplines can help to facilitate testable hypotheses for prevention science and explain potential limitations of current intervention approaches.     

Anemia management in heart failure: a thick review of thin data

Heart failure is defined as the inability of the heart to pump blood at an amount sufficient to meet the metabolic needs of the body. In heart failure, the inability to meet the body's metabolic needs is based on hemodynamic derangement and suboptimal oxygen-carrying capacity of the blood itself. Current pharmacologic therapy attempts to improve survival and reduce symptomatology by optimizing hemodynamics to increase oxygen delivery, but does not address oxygen-carrying capacity. Unfortunately, there is a high prevalence of anemia in patients with heart failure, which compromises oxygen-carrying capacity, is an independent predictor of mortality, and may be caused in part by pharmacologic agents that confer morbidity and mortality benefits in this population. Recombinant human erythropoietin supplementation improves the functional capacity of the failing myocardium, reverses and antagonizes the detrimental remodeling induced by autoimmune activity, and may reduce mortality and morbidity among patients receiving maximal pharmacologic therapy for heart failure. However, limited clinical data prohibit widespread recommendations for its use in patients with heart failure.